Abstracts

Rationale:
Epilepsy is a common neurological disorder affecting one in every 26 persons. A third of patients with epilepsy are refractory to medical therapy, and should be referred to a comprehensive epilepsy center for further management. There is currently an average of 19 years of delay in referral to epilepsy centers in the nation. Medical provider attitudes towards refractory epilepsy and epilepsy surgery referral is a barrier. This study assessed general knowledge and attitude towards refractory epilepsy and epilepsy surgery among medical providers
Method:
Questionnaires were distributed to medical providers in the University of Utah Health system. These providers included Neurology (epileptologists excluded) and Non Neurology (primary care) attendings, fellows, residents, medical students, physician assistants and nurse practitioners. The questionnaire consisted of nine questions of general knowledge of refractory epilepsy, referral timing to a neurologist, referral to a comprehensive epilepsy care center, barriers to referral, surgical evaluation of epilepsy, and surgical options and benefits of epilepsy surgery.
Results:
Twenty nine medical personnel responded to the questionnaire; comprised of nine attendings, two fellows, 10 residents, five medical students, one physician assistant and two nurse practitioners. There were 16 personnel in Neurology group and 13 in Non Neurology group. The definition of “refractory epilepsy” was known in 69% in the Neurology group vs 31% in Non Neurology group (p=0.045).  Awareness about when to refer to a Neurologist was 44% in Neurology group vs 31% in Non Neurology group. Awareness about when to refer to a comprehensive epilepsy center was 12% in the Neurology group vs 8% in Non Neurology group. Awareness about what is the average time from onset of epilepsy to referral to a surgical epilepsy center in the nation was 19% in Neurology group vs none in Non Neurology group. Both groups showed 100% awareness about increased mortality rate in individuals with refractory epilepsy. General knowledge and awareness of refractory epilepsy was better in the trainees (fellows, residents and medical students) versus practitioners.
Conclusion:
A significant proportion of Neurologists and Non Neurologists are unaware of the definition of refractory epilepsy and when to refer to comprehensive epilepsy centers for surgery. This may result in suboptimal care of patients especially with refractory epilepsy. Knowledge and awareness are better among trainees about refractory epilepsy than practitioners. There is a greater need to disseminate the knowledge about refractory epilepsy to allow patients to have timely access to treatment. Awareness in the cohort about increased mortality in refractory epilepsy population was encouraging.
Funding:
:None